2017 Cornerstone Missionary Baptist Church Family Camp / Summer Retreat


Camp Dates:
Begins: Wednesday, July 5 at 6:00 PM
Ends: Saturday, July 8 by 12:00 PM

Location:
Wisconsin Church of God Camp & Retreat, Rock Springs, WI


Pre-Registration and $10 Non-Refundable Deposit due by May 28, 2017.


Final Payment due no later than June 18, 2017.

    Registration, Medical Release, Consent, and Emergency Contact

    ALL Campers must be registered. Only ONE Camper per form.
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    Emergency Notification Information

    Must be completed for ALL campers, regardless of age.
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    Authorization to Participate, Consent to Photograph, and Medical Release

    I hereby grant my permission for the above named Camper to participate in the Family Camp/Summer Retreat organized and conducted by Cornerstone Missionary Baptist Church. I give permission for Cornerstone representatives to photograph and video record myself and/or my child as a part of program activities, and I allow any photos or videos that include me and/or my child to be published at the discretion of Cornerstone Missionary Baptist Church representatives. Further, I hereby grant permission for any adult participant of said program to seek and authorize emergency medical attention and treatment on behalf of myself in the event I become injured or incapacitated, and/or my child in my absence, and hereby release Cornerstone Missionary Baptist Church and its members/assigns from any and all liability associated therewith.
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    Authorized Medications and Other Pertinent Health Information

    Must be completed for ALL campers.
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